重组人尿激酶对急性ST段抬高型心肌梗死的临床疗效及炎症因子的影响
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摘要
目的探讨重组人尿激酶对急性ST段抬高型心肌梗死的临床疗效及炎症因子的影响。方法选取2016年3月—2018年3月在三门峡市中心医院住院治疗的ST段抬高型心肌梗死患者110例,采用随机数字法分为研究组(55例)和对照组(55例),对照组患者给予常规治疗,研究组患者在常规治疗的基础上给予重组人尿激酶进行治疗,比较两组患者的血管再通率及主要不良心血管事件(MACE)的发生率,并测定治疗前后超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、单核细胞趋化蛋白(MCP-1)、人组织纤溶酶原激活物(t-PA)和人纤溶酶原激活物抑制剂(PAI-1)的水平。结果研究组患者的血管再通率为81.82%,对照组患者的血管再通率为63.64%,差异具有统计学意义(P<0.05)。治疗前,两组患者的PAI-1、t-PA、hs-CRP、IL-6及MCP-1相比,差异无统计学意义;治疗后,两组患者的hs-CRP、IL-6及MCP-1水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且研究组患者的hs-CRP、IL-6及MCP-1显著低于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者PAI-1明显降低,而t-PA显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且研究组患者PAI-1显著低于对照组,而t-PA显著高于对照组,差异具有统计学意义(P<0.05)。研究组患者的MACE发生率为6例(10.91%),对照组患者的MACE发生率为17例(30.91%),差异具有统计学意义(P <0.05)。结论重组人尿激酶能够显著提高急性ST段抬高型心肌梗死患者的血管再通率、降低炎症反应及主要不良心血管事件的发生率。
Objective To investigate the effect of clinical effect and inflammatory factor of prourokinase in the treatment with STsegment elevation myocardial infarction.Methods 110 cases ST-segment elevation myocardial infarction patients from March 2016 to March 2018 in our hospital,according to the random number divided into research group(55 cases) and control group(55 cases),the control group was given routined treatment,the research group was given recombinant human urokinase on the basis of routine treatment,compared with the vessel repass rate and the incidence of the major adverse cardiovascular events,and tested the level of high-sensitivity C-reactive protein,IL-6,monocyte chemo-attractant protein-1,human tissue-plasminogen activator and human plasminogen activator inhibitor 1.Results The vessel repass rate of the research group is 45 cases(81.82%),the vessel repass rate of the 35 cases(63.64%),the difference was statistically significant(P<0.05).Compared with the PAI-1,t-PA,hs-CRP,IL-6 and MCP-1 of the two groups before treatment,the difference was not statistically significant.After treatment,the PAI-1,hs-CRP,IL-6 and MCP-1 of the research group was significantly lower than control group,but the t-PA significantly increased,the difference was statistically significant(P<0.05).The incidence of MACE of the research group is 6 cases(10.91%),the incidence of MACE of the control group is 17 cases(30.91%),the difference was statistically significant(P<0.05).Conclusion Prourokinase can significantly improved the vessel repass rate of the acute ST-segment elevation myocardial infarction,and decreased the inflammatory response and the incidence of the major adverse cardiovascular events.
Objective To investigate the effect of clinical effect and inflammatory factor of prourokinase in the treatment with STsegment elevation myocardial infarction.Methods 110 cases ST-segment elevation myocardial infarction patients from March 2016 to March 2018 in our hospital,according to the random number divided into research group(55 cases) and control group(55 cases),the control group was given routined treatment,the research group was given recombinant human urokinase on the basis of routine treatment,compared with the vessel repass rate and the incidence of the major adverse cardiovascular events,and tested the level of high-sensitivity C-reactive protein,IL-6,monocyte chemo-attractant protein-1,human tissue-plasminogen activator and human plasminogen activator inhibitor 1.Results The vessel repass rate of the research group is 45 cases(81.82%),the vessel repass rate of the 35 cases(63.64%),the difference was statistically significant(P<0.05).Compared with the PAI-1,t-PA,hs-CRP,IL-6 and MCP-1 of the two groups before treatment,the difference was not statistically significant.After treatment,the PAI-1,hs-CRP,IL-6 and MCP-1 of the research group was significantly lower than control group,but the t-PA significantly increased,the difference was statistically significant(P<0.05).The incidence of MACE of the research group is 6 cases(10.91%),the incidence of MACE of the control group is 17 cases(30.91%),the difference was statistically significant(P<0.05).Conclusion Prourokinase can significantly improved the vessel repass rate of the acute ST-segment elevation myocardial infarction,and decreased the inflammatory response and the incidence of the major adverse cardiovascular events.
引文
[1]国家卫生计生委合理用药专家委员会,中国药师协会.急性ST段抬高型心肌梗死溶栓治疗的合理用药指南[J].中国医学前沿杂志:电子版,2016,8(8):25-41.
[2]杜立峰.阿替普酶与尿激酶分别联合依诺肝素钠治疗急性ST段抬高型心肌梗死(STEMI)的临床疗效、安全性和经济性分析[J].中西医结合心血管病电子杂志,2017,5(6):1725-1728.
[3]马国华,宋心愿,谢松波.注射用瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死的效果及安全性[J].药物评价研究,2017,40(9):1315-1318.
[4]冷闰杰,刘晓红,李岩,等.重组人尿激酶治疗急性ST段抬高型心肌梗死的疗效及对血清C反应蛋白、补体C3的影响[J].疑难病杂志,2016,15(2):135-138.
[5]高海英,高小冬,黄红丽,等.重组人尿激酶原对ST段抬高型急性心肌梗死患者血浆纤溶因子及血管再通的影响[J].解放军医药杂志,2016,28(8):65-68.
[6]姚朱华,陈湾湾,曹明英,等.注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效和安全性及影响因素分析[J].中国全科医学,2016,19(9):1061-1066.
[7]朱利娟.注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效和安全性及影响因素分析[J].中西医结合心血管病电子杂志,2017,5(26):60
[8]曾辉,韩风杰,杨长宝,等.经靶向灌注导管应用重组人尿激酶原对行急诊PCI术的急性ST段抬高型心肌梗死患者心肌血流灌注的影响[J].中国实用医刊,2017,44(14):5-8.
[9]李晓华,王佩园,冯宗斌,等.注射用重组人尿激酶原与注射用阿替普酶治疗急性ST段抬高型心肌梗死的成本-效果分析[J].临床药物治疗杂志,2017,15(4):35-38.
[10]蔺宇,马丽娜.瑞舒伐他汀对老年急性冠脉综合征患者IL-6、GMP-140、BNP及心功能的影响[J].中国生化药物杂志,2017,37(11):56-57.
[2]杜立峰.阿替普酶与尿激酶分别联合依诺肝素钠治疗急性ST段抬高型心肌梗死(STEMI)的临床疗效、安全性和经济性分析[J].中西医结合心血管病电子杂志,2017,5(6):1725-1728.
[3]马国华,宋心愿,谢松波.注射用瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死的效果及安全性[J].药物评价研究,2017,40(9):1315-1318.
[4]冷闰杰,刘晓红,李岩,等.重组人尿激酶治疗急性ST段抬高型心肌梗死的疗效及对血清C反应蛋白、补体C3的影响[J].疑难病杂志,2016,15(2):135-138.
[5]高海英,高小冬,黄红丽,等.重组人尿激酶原对ST段抬高型急性心肌梗死患者血浆纤溶因子及血管再通的影响[J].解放军医药杂志,2016,28(8):65-68.
[6]姚朱华,陈湾湾,曹明英,等.注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效和安全性及影响因素分析[J].中国全科医学,2016,19(9):1061-1066.
[7]朱利娟.注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效和安全性及影响因素分析[J].中西医结合心血管病电子杂志,2017,5(26):60
[8]曾辉,韩风杰,杨长宝,等.经靶向灌注导管应用重组人尿激酶原对行急诊PCI术的急性ST段抬高型心肌梗死患者心肌血流灌注的影响[J].中国实用医刊,2017,44(14):5-8.
[9]李晓华,王佩园,冯宗斌,等.注射用重组人尿激酶原与注射用阿替普酶治疗急性ST段抬高型心肌梗死的成本-效果分析[J].临床药物治疗杂志,2017,15(4):35-38.
[10]蔺宇,马丽娜.瑞舒伐他汀对老年急性冠脉综合征患者IL-6、GMP-140、BNP及心功能的影响[J].中国生化药物杂志,2017,37(11):56-57.